Occurrence of Post-Transplant Lymphoproliferative Disease in a Renal Transplant Patient

Post-transplant lymphoproliferative diseases (PTLD) are a group of lymphoid disorders that occur in the setting of solid organ or hematopoietic transplantation. Risk factors for the development of PTLD include type of organ transplanted, degree/duration of T-cell immunosuppression, and Epstein-Barr virus (EBV) status. After initial infection, EBV lies dormant in memory B-cells and persists at low levels throughout the lifetime. In an environment of chronic T-cell immunosuppression, the underlying EBV infection remains uncontrolled, resulting in malignant B-cell lymphoproliferations that causes PTLD.  While PTLD is the most common malignancy associated with solid organ transplants, they are a serious complication and require a low threshold of suspicion for diagnosis. Oftentimes symptoms are nonspecific, such as weight loss and malaise, and many patients present without associated lymphadenopathy. We present the case of a 30-year-old Asian American female who developed PTLD, specifically large B-cell non-Hodgkin's lymphoma, five years after receiving a deceased-donor renal transplant.